Most physicians participating in this study conducted in Ghana were willing to play some role in the provision of safe abortion services.

ObjectiveTo examine the social and ethical challenges in enforcing sexual and reproductive rights of male and female adolescents abused at sexual debut in Ghana.MethodologyThis was a secondary analysis of cross‐sectional survey data on 278 sexually experienced male and female teenagers from 12 communities selected by cluster random sampling in the Ejisu‐Juben district. We extracted relevant data from a 2009 academic thesis project involving 481 respondents. We assessed differences between sexual debut experiences of males and females using Pearson's chi‐square and ANOVA tests. P‐values ≤0.05 were considered significant.ResultsMean ages at sexual debut for males and females were 16.05 ± 1.8 and 15.98 ± 1.47 years respectively (P=0.719). Adolescents of both sexes experienced defilement and forced sexual debut; similar proportions had early sexual debut. Females who had early sexual debut were more likely than their older counterparts to have low educational attainment and induced abortion.ConclusionsMany male and female adolescents experience sexual and reproductive rights breaches at sexual debut. Prevailing circumstances hinder optimization of sexual and reproductive rights of juveniles in Ghana. We recommend making clear provisions for young persons in the law on sexual offences in the criminal code to facilitate development of interventions to improve access to justice for offenders and victims.

Background Self‐managed abortions (SMAs) remain a public health challenge; and are worst in deprived settings. In this policy review, we sought to analyze the legal and policy frameworks within which SMA occurs and look at how these may help improve abortion outcomes in Ghana. Methods We searched and reviewed documents on “self‐induced” or “self‐managed” abortion in Ghana from 2015 to 2022. Databases searched included Ghana Digital Attorney, PubMed Central, Google Scholar, and Repositories of Public Universities in Ghana. The key documents reviewed included the abortion law (Act 29) of Ghana, the fourth (2021) edition of the Ghana Health Services’ Comprehensive Abortion Care Standards and Protocols, and the 2017 Maternal Health Survey report. Key documents reviewed included amended Act 29, Comprehensive Abortion Care policy, and standards. We then performed policy analysis using Walt and Gilson's policy triangle framework regarding the context, practice, processes, and key players. Results After a careful review of the literature, the following key themes emerged in the framework analysis: the policy environment for SMA, the practice of SMAs, key players of SMAs, consequences of induced abortions, the abortion law, and criminal connotations of SMA. We found that SMAs remain criminalized in Ghana but the local practice persists with the use of registered and unregistered abortifacients. We also observed frequent criminal connotations of SMAs in the literature but no evidence of related prosecutions. There was limited empirical evidence on the safety and efficacy of SMAs in Ghana. Conclusion From our findings, we contend that there is an unduly high criminal connotation of SMA in Ghana. We, therefore, recommend a multilevel stakeholder engagement to decriminalize SMAs to ensure improved access to safe abortions in Ghana.

This paper sought to ascertain the extent to which litigation is highlighted in reports on maternal deaths in the Ghanaian media. Using internet search we reviewed reports on maternal death in the media from January, 2013 to December, 2018. Thematic analyses of the reports that satisfied the inclusion/exclusion criteria were performed. It was established that healthcare leaders and key state personalities have through the media created good public awareness about unacceptably high maternal deaths in the country. The root causes were highlighted. Only few case reports were presented and there had been scanty emphasis on using legal means of addressing the problem of inadequate access as a human rights violation. In conclusion rights-based approach to addressing poor maternal health challenges in Ghana is grossly underutilized. Stakeholders are encouraged to include the option of using legal redress as a means of ensuring government and healthcare providers keep their promise of providing quality maternity care to reduce preventable deaths of women.

BackgroundDespite a liberal abortion law, access to safe second trimester abortion services in Ghana are challenging for many women. This study sought to examine providers, methods employed, cost, and other determinants of availability of second-trimester abortion services in health facilities in Accra, Ghana in 2019 to inform policy and program decisions. MethodsA two-stage mixed quantitative and qualitative study designs were employed in the conduct of this study. The rst stage was a short interaction of the mystery client with a clinical care provider to identify health facilities that provide second trimester induced abortion, the cost, and referral practices, where the facility did not have the service. The second stage was in-depth interviews of second-trimester abortion care providers and non-providers in various health facilities. For internal validity, it also explored the procedure cost, referral, and other practices at the health facilities included in the study, independent of what was captured in the mystery client survey. ResultsSecond-trimester abortion services in Accra, Ghana are widely unavailable even in most facilities that provided abortion services. Referral policies and practices indicated by the service providers at various facility levels were inadequate. Criminalization of the procedure, social stigma, and fear of complications are the main factors that adversely in uence the availability of second-trimester abortion in health facilities in Accra. ConclusionsAlbeit increasing demand for second-trimester abortion in health facilities in Accra, services are not readily available due to the ambiguity of the law, its interpretation, and limited ow of accurate information on providers. Policies and programs that limit access to Second-trimester abortions in Ghana are amendable to ensure safe services. BackgroundAccess to safe abortion care according to the World Health Organization in 1995 is a fundamental human right. As essential health care in most nations including Ghana, safe abortion services are expected to be available at high standards that are acceptable and accessible to all people within local jurisdictions. Traditionally, abortion care is divided into two: rst trimester (week 1 through week 13) and